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HomeMy WebLinkAbout3444DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 73.18 -1 -13 BOX 27 r 4: • r � sm 1r , yz m ME kP 03444 PUTNAM COUNTY DEPARTMENT OF HEALTH . � A••r0 .z — . .....� :: w:b _ � D. �. �.I. ..V...neI.- ..S- FI+c- Oe•»N r �aO*•.'wGF �^. �E...rNV IR., —O.... N_ M•:�.E. NT x V'tiw _ ^•i.-- nH meirt? �-..a .� I T.H- SERVICES a..... r� - w..r......w e..e,-r_cwa+.+v'•-setsr -+ ... Y .= CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCItD CONSTRUCTION PERMIT # PV_ 7" T5 Located at (F�srl�w t.�,aca2 c.st,�E> Town Village Owner /Applicant Name 37 0AVr /DA9 7z >&z1*,1faxMap 73. °8 Block Lot 1 Formerly Subdivision Name L a^�cAn Subd. Lot # Mailing Address 0951M A✓C7 _ IV! J Zip • t c•,56Z_ i Date Construction Permit Issued by PCHD 10 --z 1 -`i7 Separate Sewerage System built by 37 C2al&4 Mol ttP. cv�r--P, Address Consisting of If Gallon Septic Tank and 4-F Z �'� (PC TXE`vc "tS i Other Requirements: I ��QN fob Fc(� Water Sup"I Public Supply From or:' 1C Private Supply Drilled by 5�,✓s „��� Address G�- �vTNA-vn A✓ �, Address 13-ae Srtz, A/ y c o5'0 / e oti, °Ns �....,. Number of Bedrooms Vi-w&*q 0cwi Has garbage grinder been installed? ,v a I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as- built plans (copies of which are attached), in accordance with the issued PCHD Construction Permit and approved plans and the standards, rules and regulations of the.Putnam County Department of Health. Date: ° -LI 61'19 Certified by P.E. X IM i Address i�5� &v6r,, etP,,j S�et�/ ,, ( ,� Tonal) ` e, License # 11 -5 / 1485- r4!1—. 2z, , OJ Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon4s a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Public Health Director, such revocat'on, modificatio or change is necessary. By: 'i / ! Title: 44. Date: '' ' i White copy - HD File; ow py - Building Inspector; Pink copy - Jvner; ge copy - Design Professional a Form CC -9? L'- -- 4 L PUT NAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT 1@1(9lt JN;: rxact location of well wttn atstances tgratAeast two permanent lanamarxs.to be pre mea on a separate sneevpian. 4 Putnam Avenue Well Driller's Name P• Vll�ons, Inc. Address: Brewster, NY 10509 Signature: Date: 12/9/98 White copy: HDTiIe; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 ^sates` Kramers Pond Road TownlV I%C' `Tax Putnam Valley Grid # � 0. �-' 6 Map `3,19 Block 0 Lot(s) Well Owner: Name: Address: V.S. Corporation, 37 Croton– Dam-- Road-Ossining NY- -10562 - Ns off Well: =I-Pgima 2- secondary X Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional" Standby IDrilling )Equipment X Rotary.. Cable percussion X Compressed air percussion Other (specify) Well Type Screened Open end casing x Open hole in bedrock Other Casing Details Total length 32 ft. Length below grade 31 ft. Diameter 6 in. Weight per foot 19 lb /ft. Materials: X Steel Plastic Other Joints: _ Welded X Threaded _ Other Seal: X Cement grout — Bentonite Other Drive shoe: X Yes No _ Liner Yes X No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes No Hours Second Well Yield Test _ Bailed Pumped X Compressed Air Hours 8 Yield 2 gg1n IDeptln Data ensure from land surface- static (specify ft) 60' , During yield test(ft) 450' Depth of co in t -.. 60 ' . .. Well Log If more detailed information descriptions or are available, please attach. Depth From Surface Water Bearing Well Diameter(in) F neat' Description ft. ft. Land Surface 11 !=den r-lay and bmldprs "' Hit roc at 111 32 605' Drillin I in roc 1 If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information Pump Type sub Capacity 5c� Depth 560' Model5GS10412 Voltage 230 HP 1 Tank Type WX302 =2 Volume 6 . each (two) Date Well tompleted 8/10/98 Putnam County Certification No. 002 Date of Report 12/9/98 We. alp 1@1(9lt JN;: rxact location of well wttn atstances tgratAeast two permanent lanamarxs.to be pre mea on a separate sneevpian. 4 Putnam Avenue Well Driller's Name P• Vll�ons, Inc. Address: Brewster, NY 10509 Signature: Date: 12/9/98 White copy: HDTiIe; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 i 1 u � i LINCA1219 •Lbt, to PUTNAM COUNTY DEPARTMENT OF HEALTH y, APPLICATION, FOR APPROVAL OF PLANS FOR A W4TEWATER DISPOSAL SYSTEM 1. Name and Address of Applicant: L INCA? DEVEAF'MENt 'CO., INC- IN LIt• E M99-Y , N-d- I169t`3 2.. Name of Project: T05 FOR UWAV- MYELoPME.Rt 3. Location T /V /C: �IfiN4M VALI�i.' Co IV40 4. Project Engineer: INgItE ENCII4EM05 AND DE W1C ,fC5. Address I�Iq i •Lo j CAR Fl, SY, 10512 License Number Coiq?SI _ Phone: q14 -225 -!dlAo . 6. T e` of Proiect. Private /Residential Food Service Commercial Apartments Institutional. Mobile,Home Park . Office Building Realty_Subdixision Other, (specify)' 7. Is this project subject to State Environmental Quality Review (SEQR) Type Status (Check One) . Type I.. Exempt Type II. Unlisted 8. Is a Draft Environmental Impact Statement (DEIS)-`required? a hb 9. Has DI ' . .... ..... ; EIS been completed and found acceptable by Lead Agency? ............ HA ' 10. Name of Lead Agency N% s° fiis "�prorij t_I'ff~e1° i�ea`t c �'i'ise eGntro��of�::'fi�ca piann� n9; = cnir� •� k or other' -officials, ordinances? . .... ........ 12. If so•'have plans been submitted to such authorities? Nb 13, ,Has preliminary approval 14. Type of Sewage Disposal I been granted by such authorities? WA Date .Granted: � j System Discharge...... "Surface Water X Ground Waters j 15. If surface water discharge, what is the stream class designation ?......... WA 16. Waters index�number;(surface) ..,......... ........, .... :.. ............. NfA 17..':.Is_.pr6ject located near a, public water supply system? .. .......... t`IO 18. 'If yes, ,name of .water supply VA ° ,.. °Di•stance to water supply N /A 19. Is "project site near ,.a 'public .sewage. ..collection or disposal system ?..... NO i 20. Name of sewage'system IWA 'Distance to sewage system. N I 21. Date observed: UN44DWR 23. ' Name of Health Inspector:. UN_K -�h� 24. Project design flow (gallons per day)...... . .. ............................. 800 G1PD 2. 25,­-Is. State - Pollutant Discharge Elimination ` Sys_tyem._(SPDES) Permit required ?.. NO 26. Has SPDES Application been submitted to local DEC Office? ............... 27.. Is any portion of this project located within a designated Town or State wetland?.... ' ............................................................. 28. Wetland ID Number .......................... o ............................. 29. Is Wetland .Permit required? - aboo- ueenuaacnneaaea >ee a o 6 a a 6—o—'a e Has application been made to Town or Local DEC Office? ..` ;.a ............. 30. Does project require a DEC Stream Disturbance Permit? ................... NO 31. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge application or industrial activity? .....e.. YES or NO NO 32. Is project located within 1,000 feet of existence of abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potential known source of contamination? ..............YES or NO ND DESCRIBE: 33. Is there a local master plan or file with the Town or Village? ........... 'ff:5 34. Are community water,.sewer facilities planned to be developed within 15 years? NO M <� a..e aij+:;;se!� 9eTdls_posal ariea,,% n- excess-., f :�5X- cps?.:. s...,.�. ,..•.....�.. >.. 1`D 36. Tax Map ID Number .......................................................... .�.9�s-a-l�, 37. Approved Plans are to be returned to: ................ Applicant Engineer If the application is signed by a person other than the applicant shown in Item 1, the application must be accompanied by a Letter of Authorization. Failure to comply with this provision may be grounds for the rejection of any submission. . - I hereby affirm, under penalty of perjury, that information provided on this form is` true to the best of my knowledge and belief. False statements made herein 'are punishable as a Class A Misdemeanor pursuant to Section 210.85 of .the Pena 1 Law. _ _._... . SIGNATURES & OFFICIAL'TITLES: MAILING ADDRESS: Punm cict,;7iY Lir-.PAiTvm?' of $rand I DIVISICN OF EWIM: MML :HEALTH SERVICES NUMER .. CLOCK PERCQ=ON PEROOLATICN I Run Elapse Depth to Water -Fra a Water Level No.: Time Ground Surface , In Inches ' Soil Rate _:,...::...:'...... Start -Stop Min. Start. Stop Drop In Min/In Drop i Inches InrhPS Tnchas 5 • • -- ems.,.. _.... __ �__,,... �...._..�_ . ..-- ..-..r 2 \ 1. Tests to be repeated' at same depth until approximately equal soil rates are obtained.at each percolation test hole. All data to'be submitted for review., 2. Depth measurerents to be made from top of hole. rev. 9/85 1 TEST PIT DATA 1RCQUI1RM 'M EQ, SJa•1IT'L D WITH APPLICI, MN HOLE N0. HOLE NO. - _ _^. _.. . t. .;;... r r'f r s -'• k�' _ `r - - ��' . "G" .•.,':. v..r. .. _ r .=.Y ' G.L. 1' ltso. M bga,M _ W ®� 5° 71 m 17 80 9' 10' 11° ' • " 12° 13' 14° -- .INDf . V E.°T - AT«(niHI `( OL TER, IS.. GT�iTERII� t� w I'c _ . , _._. _ a , _ z .... INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED DEEP HOLE OBSERVATIONS MADE BY :. b'6-Lt:> )-I% t4 & C=241EUULSt P.G. DATE: � 1 /27 7 DESIGN Soil Rate Used �% ��� Min /1" Drop: S.D. Usable Area Provided No. of Bedrooms Septic Tank Capacity 125 gals. Type co1�lC Absorption Area Provided By 44+ L.F. x 24" width trench Other 1 °-C�. �.` Ftl..1 -. Name . 4 DFSIQ31 C.Signature ! Address 1 "®1 'RoUXS Co SEAL �. THIS SPACE FOR USE BY HEALTH DEPAPMUM ONLY: Soil Rate Approved sgeft/gal. Checked by Date _____ I ' Inslte Englneedng & Design, P.C. 1849, Rt. 6 Carmel, NY 10512 Phone: (914) 225-6200 Fax: (914) 225-6438 TO PST r4QM ccklNTy I- TE4j -Tip DIF-Pi • I > WE ARE SENDING YOU Attached ❑ Under separate cover via the following items: • I ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications O Copy of letter ❑ Change order ❑ L [EcTurn O[F U MIit1U OOMO U' ZZ DATE JOB NO. ATTENTIO RE: LOT 1!o ss a5 LIt�1C,0�- a SUJ3AN ►51p I PC. - 1 i COPIES DATE NO. DESCRIPTION PC. - 1 LETT � T- zt- log. ►Z1aTlot� I 3 %7, 3I�� - I.,.E LL P I =P_MIT &F F>UC1_YTl0t -4 3/9 /q C-1 (Z(5 tl �'T 3CT I.CIJ pgzL&" I N C _ F Irk P4,1_7 6,c-p,100'06 �k ' THESE ARE ':TRAN SiVIMTM�`_as "checked below:.... _ For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution > ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US I REMARKS COPY TO i SIGNED: If enclosures are not as noted, kindly notify us at once. I � I Ronald and Marlene Orlando 26 Luigi Road Putnam Valley, New York 10579 January x, 1999 Michael Budzinski, P.E. Putnam County Health Department Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 RE: Putnam Valley - Lincar III Subdivision (Lots 6 & 7) and Adjoining Orlando Well Dear Mr. Budzinski: We hereby withdraw all prior complaints filed by us (directly or through our attorneys, Harkins and Hunte) with respect to the above matter, and consent to the issuance of necessary compliance documentation with"respect to Lots 6 and 7 in the Lincar III subdivision. Further, we waive and release V. S. Construction Inc. from performing those actions specified in a December 30, 1998 letter to you from V.S. Construction Corp. and prior letter from your .Department , -dated 12_• , / 2^ 4/a 9 8 (r a s sam er.w - ,.t.o e -.- and -.- p erx= =ar.enms . r lan .. . o. pr.. op s ; r-tto . y) � - _ � '+ < a �...9 . Qo. .a:•; =�._ o. Finally, we agree to hold your Department and the County of Putnam harmless from any and all further claims regarding this matter. Sincerely, R_ ONALD ORLANDO � f o MkRLENE ORLANDO cc: Hon. Robert J. Bondi, County Executive Hon. Sam Oliverio, Jr. County Legislator Bruce R. Foley, Public Health Director William Hodges, Department of Health Charles Anderson, Supervisor, Town of Putnam Valley Iry Sevelowitz, Building Inspector, Town of Putnam Valley Referred for handling Attached as requested I Returned as requested Please see me I. -° Read and return COMMENTS: p�se�ss 37 CROTON DAM ROAD, OSSINING, NEWYORK 10562 BUS. (914).739-7362 FAX (914) 739 -7156 December 30, 1998 Michael Budzinski, P.E. Director of Engineering Putnam County Department of Health Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 RE: Lot #6 and Lot #7, Lincar III Subdivision aka Woodland Estates and Adjoining Orlando Well Dear Mr. Budzinski: With reference to your letter of December 24, 1998, this will serve to confirm that the requirements with respect to Woodland Estates Lots 6 & 7 have been satisfied, and that no further assurances from our firm are required. - With respect to the Orlando well we agree that: 1. We will install additional water storage. tanks as may be necessary tol provide a total of no less than 174 gallon water storage capacity at the Orlando site; and 2. For a period of 5 years from today's date, we will take such steps as may be necessary to insure a well yield of no less than 2.gallons per minutes at the end of an 8 hour pump test period. �x �® BRUCE R..$OLy: Public Health Directors DEPARTMENT OF 'HEALTH Division of Environmental Health Services 4 Geneva . Road Brewster, New York � 10509 Tel. (914) 278-6130. Fax (914) 278-7921 December 24, 1998 William Bricklemaier III, P.E. Insite Engineering & Survey Route 22 Brewster NY 10509 Re: Well Testing Results Lot #6 and Lot #7, Lincar 3 Subdivision a.k.a. Woodland Estates and Adjoining Orlando Well Dear Mr. Brickelemaier: This Department has received and reviewed the results of the eight -hour pump test conducted (simultaneously) on the three above - mentioned wells. T'he results indicate'that the well on Let #7 -began at teri gallons per minute and at the end of the eight -hour pump test, maintained a yield of five gallons per minute. I The well on Lot #6 and the Orlando well, however, both demonstrated a yield of 2 gallons per minute at a period of seven hours and five hours into the test respectively. Based on the results of these test, you have proposed the following mitigation measures for these wells. A) The installation of flow restrictors on the wells of Lot #6 and Lot #7 to limit the output of these wells to a maximum of 5 gallons per minute. B) The installation of 174 gallon storage tanks on the well serving both Lot #6 and the Orlando well to insure adequate water during peak demand. It is noted that the reported yield of the existing Orlando well was ten gallons per minute prior to the construction of the Lot #6 and Lot #7 wells and hydro- fracking these wells directly affected the Orlando well. Although the Orlando well was deepened to insure adequate water, the existing yield is now reported to be 2 gallons per minute. . 1 I Letter o� Wliam Brickelemaier December 24 "1998 This Department would like to insure adequate water to both the new owners of Lot #6 and Lot #7, as.well as; insure that the water supply to the Orlando residence is not adversely affected. . Therefore, this Department will accept the proposed installation of the flow restrictors, limiting the output of these wells to five gallons per minute, on Lot #6 and Lot #7. Also, the installation of storage tanks of 174 gallons to be installed on Lot #6 and the Orlando residence. This Department would also like assurance that the developer, Mr. Santucci, would agree to correct any problems which may arise with these wells, for a period of not less than five years. Please draft an outline addressing these assurances and submit it to this Department for review and approval Should you any questions concerning this matter, please contact me at your convenience. 1. Very truly yours, Uj Michael Budzi ski Director of E ineerin� I 1)N S TE _ ENC /NEE/ /NC .:SURVEY /NG; &'; - � LANDS§N iE RCH /TECTURE P.C. November 16, 1998 I Mr. Bill Hedges Putnam County Health Department Division of Environmental Health Services 4 Geneva Road I Brewster, New York 10509 RE: Well Testing Results For ! Lots 6 and 7 Lincar 3 Subdivision (a.k.a. Woodland. Estates) 1. . and Adjoining Orlando Well Dear Mr. Hedges: Enclosed please find a copy of the well test results for the three above referenced wells. Based on the results of this testing and discussions with the well driller (P.F. Beal & Sons), it is our office's opinion that there is' j adequate water available to supply the three subject lots. Our office met with Mike Budzinski on Thursday, November 12 to discuss the results. During this meeting, it was agreed that flow restrictors would be installed in the well lines from Lot 6 and 7 to limit the flow rate from these wells to 5 gpm. It was also agreed that additional storage would be provided in accordance with the Putnam County Health Department requirements for wells with yields less than 5-gpm. The minimum storage tank requirements are calculated as follows: Qavg = 4 Bedrooms x 200 gpd/bedroom = 800 god = 0.56 gpm Qpeak =10 x Qavg = 10x0.56 gpm = 5.6 gpm Peak Demand Deficit = Qpeak — Qtest = 5.6 gpm — 2. gpm = 3.6 gpm Volume of Effective Storage Required = 15 min. x Peak Demand Deficit = 15 min x 3.6 gpm = 54 gallons PIOninimum absolute operating- pressure) =-30 psi (gage) + 14.7 psi (atmospheric) = 44.7 P2(maximum absolute operating pressure) = 50 psi (gage) + 14.7 psi (atmospheric) = 64.7 Volume of Storage Tank Required = Volume of Effective Storage Required = 54 gallons = 174 gallons 1-PI 1 -44.7 P2 . 64.7 Based on the.aboye.calculation, a minimum.total storane.tank volume of .174,.galloos:.vtrilF.ti'e provided for bofli Loft #6 �znd llie Qrland�wEifi '' _ . , ....v . Our office will advise the well driller /plumber to install the above referenced flow restrictors and storage tanks upon receipt of acceptance from your department. Should you have any questions or comments regarding this information, please do. not hesitate to contact our office. Very';truly yours, INSITE ENGINEERING, SURVEYING & LANDSCAPE ARCHITECTURE, P.C. By: William J. Brickelmaier, III, P.E. Project Engineer, Associate WJB /jms Enclosure cc: Michael J. Budzinski, P.E., Putnam County Health Department Val Santucci, VS Construction Insite File No. 91147.400 1116998bh.doc i ❑ 1485 Route 22, Brewster, New York 10509 (914) 278 -4990 Fax: (914) 278 -6392 ❑ 7 DeLavergne Avenue, Wappingers Falls, New York 12590 (914) 297 -1742 www.insite- eng.com S Il V o PoLL 'b Q16�L SON S9 y 4 PUTNAM AVENUE ARTESIAN WELLS k3REWSggTER, FLEW YORK 10509 WATER TANKS • WATER SYS'fMS • — ;' — 7.;, — Qc*Gt !1, O llk!!a` � .;COMMERCUIL.WATER SYSTEMS JETPUMPS PL �m7""`" f HMROFRACTURING SUBMERSIBLE PUMPS TEL. 279 -2460 - 2461 WATER CONDITIONING EQUIPMENT FAX 279 -6613 COMPLETE INSTALLATION, REPLACEMENT AND REPAIR SERIVICE ye B ,, CORPORATION 3 Well Test -.11/4/98 cc: Val Santucci, V. S. construction John Watson, Insite Engineering -- Woodland Estates Ronald Orlando Lot #6 Lot #7 26 Luigi Drive Time Flow Water Level Flow Water Level Flow Water Level 11:20 10 gpm 60' 10 gpm 50' 10 gpm 55' 11:30 10 gpm 75' 10 gpm 70' 10 gpm 65' 11:45 5 gpm.. 85' 5 gpm 84' 5 gpm (throttled output .from pumps to 5 gpm) 12:00 5 gpm 95' 5 gpm 90' 6 gpm 85' 12:15 5 gpm 130' 5 gpm 130' 6 gpm 90' 12:30 5 gpm 170' 5 gpm 170' 6 gpm 93' 12:45 5 gpm 190' 5 gpm 185' 6 gpm 95' 1 :00 5 gpm 210' 5 gpm 200' 6 gpm 145' 1:30 5 gpm 245' 5 gpm 235' 5 gpm 2151 . 2:00 5 gpm 277' 5 gpm 265' 5 gpm 285' (let pumps pump full capacity as directed by engineer) 2:30 7 gpm 324' 7 gpm 300' 6 gpm 395' 3:00 7 :gpm.,. :385!:,: .� ... 7 gpm 300' S gpm 3.30 7.-gptii <... 400' - -,7 _gpm - 400' 4 .fpm 4:00 5 gpm 429' 7 gpm 400' 2 gpm at pump 4:30. 5 gpm 440' 7 gpm 420' 2 gpm " 5:00 5 gpm 445' 7 gpm 420' 2 gpm " 5:30 4 gpm 450' 7 gpm 425' .2 gpm " 6:00 4 gpm 450' .� 7 gpm 420' 2 gpm 6:30 7:00 4 2 gpm • 450' e' 4 5 0' a pt� 7 5 gpm 420' 420 ' �°M'�`� 2 2 gpm " " gpm lev<I gpm :t(& l`0� gpm 7:20 2 gpm 450' 5 gpm 420 2 gpm " (shut down) cc: Val Santucci, V. S. construction John Watson, Insite Engineering -- /'N S �� /� T PE ENGINEZERING,-SURVEYING LANDSCAPEARCHIMMIRE, P.C. Route 22 71- (9-11-4)zt784990 Brewster, New York 10509 '(914) 278-6392 71 Del-averg ne Avenue (914) 297-1742 Wappingers Falls, New York 12590. TO: LETTER OF TRANSMITTAL Date: 6Z I(- qo* NO. Job No. 91 Attn: AIVkvA 5-ri cr3 CL/ e-hi Re: jl,.jcery 4c7-6 to - WE ARE SENDING YOU Attached ❑ Under separate cover via ❑ Shop Drawings ❑ Prints ❑ Plans ❑ Copy of Letter ❑ Change Order ❑ ❑ Samples the following items: ❑ Specifications COPIES DATE NO. DESCRIPTION I q--,q -T 6 ......... . A157-1 A-5—i3u(-T— P"Wim -- to - 6 a A""/ -re5- M-8- ctlB ....... . ....... ........ .......... .......... . .................. . .. . ... ........... .............. .................. ........... ------- . ...... ............. ........................... I ........................ * ............ ... . ..................... . . .............. . .. . .. . ......... . ... . .................................................................. ...................... . ........... . THESE ARE TRANSMITTEI Ell For Your use ❑ As requested ❑ For review and comment REMARKS: as checked below: ovpd.as submitted,.. ❑ Approved as noted ❑ Returned for corrections ,.P,R��q�n copies for approval q lit, ❑ Submit copies for distribution ❑ Return corrected prints ------------- .................................................................... COPY TO: SIGNED: IF ENCLOSURES ARE NOT AS NOTED, KINDLY NOTIFY US AT ONCE Lot98.dot FUTNAM COUNTY DEPARTMENT OF HEALTH DIVIySION OF ENVIRONMENTAL HEALTH SERVICES �:._... ._.7 -__j.r _, eT.J �J'•.tF.:�.R10�:_.J � r �_.- r.._�r,_�Z•4�si- •'°t'1. D:.. .. � ♦ .._:. M�.: itYf - --DaL �.�,5- .4JO_. ✓ l �'...� �.t .b'.T.�� \;` T'RJr'is ": .. .. _ . GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM 3 % CRotar4 PKM Flo ^v LoAp. Owner or Purchaser of Building Building Constructed by COft1hp 40VXr C9"O'ccMOQ&,y 1_114rAZ LeN6, Location - Street RD'SiDE. WrIAI- Building Type 73. 1 e 1 13 Tax Map Block Lot 17orN/arv%. Val -!sue y Town/Village Subdivision Name Subdivision Lot # I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of. two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system, The undersigned further agrees to accept as conclusive the determ' iat ni qg the b ic Health D�ector of the Putnam County Department of Health as to whether or no the rl'ilure' the system toope ate tas ed by the willful or negligent act of the occupant of e ildin � tilizing the sy*en� E i dated: ii *�Ith ` /Q Day 5 Year Signature: (Owner) - Signature 7 C- Rcr-0 IN aA n i Z 0 A D C ©1 Corporation Name (if corporation) Address: 37 c �? oT-o , \( DAM R d.A r) Title: ?PES (DAN T- Corporation Name (if corporation) Address: Sate 0SS i N IN 6 . N Y Zip ©s z State Zip Form GS -97 NORTHEAST LABORATORY OF DANBURY CT Cert: PH -0404 '3x3 =3 11RYi.I PFsAlE>�F "REiAiD - I�fkNB>�R'Y•� �T 3f $11 ' = y -Cert: (203) 748 -7903 - FAX (203) 748 -0652 LABORATORY REPORT -- WATER SUPPLY TESTING REPORT TO: PR BEAL & SONS 4 PUTNAM AVENUE BREWSTER, N.Y. 10509 SAMPLE SITE: SAMPLING POINT: SOURCE -. TREATMENT: TEST PERFORMED BACTERIAL: Total.Coliform (Bacteria) PHYSICALS: pH 12/2- Turbidity DATE SAMPLE COLLECTED: 11/20/98 & 12/2/98 TIME COLLECTED: 8:00 A.M. & 1:00 P.M. 1 COLLECTED BY: W. MAYERS DATE RECEIVED @ LAB: 11/20/98 & 12/3/98 . TESTED BY: LAB #11471 & 11301 REPORT DATE: 12 /8/98 V.S. CONSTRUCTION, LOT #6, WOODLAND EST., PUTNAM VALLEY, N.Y. HOSE BIB WELL NONE RESULT: MAXIMUM CONTAMINANT LEVEL I i 0 per 100 ml 0 per 100 ml I 6.97 no designated limit 0.26 NTUs 5 NTUs I CHEMISTRY: Nitrite N <0.01 mg/L as N 1 mg/L as N 113 01 - Nitrate N 1.4 mg/L as N 10 mg/L as N Alkalinity 82.0 mg/L no designated limits - Hardness 84.0 mg/L no designated limits 12/2 -Iron. <0.03 mg/L 0.30 mg/L Manganese------ b.O'i5''. . =i a- <-.. _.. - -- ;0:- 3.0 =inwiL ;:_ [Note: Combined Limit for Iron plus Manganese = 0.50 mg/L] Sodium 6.1 mg/L 20 mg/L ** Lead <0.005 mg/L 0.015 * ** j ml = milliliter mg/L = milligrams per Liter ND = none detected . NTU =Units * *Notification Level ** *Action Level 1 RESULTS BASED ON SAMPLES SUBMITTED: 11/20/98 & 12/3/98 i SAMPLE, AS TESTED ABOVE: MOTABLE or AMN' OT POTABLE i (PER NEW YORK STATE DEPT. OF HEALTH SERVICES STANDARDS FOR POTABLE WATER) , Laboratory Director • I •NORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 060379 (860)828 -9787 - FAX (860)829 -1050 TOLL FREE WITHIN CT: 800-826-0105 OUTSIDE CT: 800 - 654 -1230 --r _ PUTNAM COUNTY DEPARTMENT OF HEAL'T'H DIVISION OF ENVIRONMENTAL HEALTH SERVICES FINAL SITE INSPECTION Inspected by: Street Locatio rrzc� 'Owner �-� �FCoRz- Town Permit # J - ? TM r ?3.18 -1 �l Subdivision L t # 1. Sewage System Area a. STS area located as per approved plans ................. b. Fill section - date of placement 3:1 barrier Lgth. _ Width Avg.Dpt c. Natural soil not stripped ......... ............................... d. Stone, brush, etc., greater than 15' from STS arez e. 100' from water course/ wetlands .......................... II. Sewage System a. Septic tank size -1,000 ... .... 1,250 ..:..other..... b. Septic tank installed level ..... ............................... c. 10' minimum from foundation .............................. d. Distribtuion Box F-7JFoutlets at same elevation -water tested...... 2. Protected below frost ....... ............................... 3. Minimum 2 ft.Original soil between box & ti Junction Box - properly set ........... ............................... engtFi required _ Length installed 2. Distance to watercourse measured F 3. Installed according to plan ............................. ,4. Slope of trench acceptable-1 /16 -1/32" /foot.. 5' 10 ft. from property line - 20 ft.- foundation 6. Depth of trench <30 inches from surface....... 7. Room allowed for expansion, 100 % .............. 8. Size of gravel 3/4 - 1 %:" diameter clean........ 9. -Depth of- gravel in trench -. 1'0: 'P'ipe ends capped ............ ............................... g. Pump or Dosed Systems Size o pump c am F r .... ............................... 2. Overflow tank ................. ............................... 3. Alarm, visuaVaudio ........ ............................... 4. Pump easily accessible, manhole to grade.... 5. First box baffled ............. ............................... 6. Cycle witnessed by H.D.estimated flow /cycl III. House/Buildin a. house located per approved plans ...................... b. Number of bedrooms ........... ............................... IV. Well a. Well located as per approved plans .................... b. Distance from STS area measured f c. Casing 18" above grade ...... ............................... d. Surface drainage around well acceptable........... V. Overall Workmanship a. Boxes properly grouted..; ............... ................. b. All pipes partially backfilled ............................., c. All pipes flush with inside of box ...................... d. Backfill material contains stones <4" diameter. e. Curtain drain & standpipes installed according f. Curtain drain outfall protected & dir.to exist w, g. Footing drains discharge away from STS area.. h. Surface water protection adequate ..................... i. Erosion control provided .... ............................... 71 ? DMaies dehi as CEIt11[±iCATS OP CO1IMANCIi NC- Rag .r gin.y �vli7i�• LI�I�1E�{r2r�� 'c -' 'cad. Iat'1I° "�� ` � Tsillsap '�.��•�•� �oe� Y" �,�t .a:'. ,.�°� ..--1 � "_�,..:..�... Qerlied ) L-(1�1 G/k(z L�—V Cr'7P n!l Si �'CJ.• i N G Senewal_ 7 Qevb ❑ Date Of Previous Approve)" Kafta Ad&. �f��l Lt.` `�-? �7„ Town 'n-*— C..l�llit�ic.inn Ar�nrn�icrl FfL.r� �"'�r�9 F0C Fnrinecrl ❑ e�_:.._} T,r I SOLI " tU V &-f— It. A. �x`� �r� i4G • �7 Depm Yolome r Number of Beieoeo _ Design Flow G P D PCHD,NollBratlou V xegnbed Wbeu F)0 Is Wlibw , Sepit.ls.Sewmr.syd m to'oomm of r! Gander Septic Tint and lid i,- �L ' .Z� . uV112C JkE,�� T12ENCi{irC Warr S11111k . From Address at X Pd,#Ae Suppby DdW by t 14 UQDV./ U.: ` Adds is �%NKl�1©lttl Omer a I ° R ,o, 1 repreant that 1 <am wholly and completely responsiple for t he aesign and location 'of the proposed system(s); 1) that the separate sew ` :disposal s stem aboire described' will be tonstructed.as shown on'theipprove0 amendment there to dreg in acswrdanee with the standartls, rules a regulations we o e ham County Oepartmant Of Moelth, and that ogcompletion thereof a'•Certificate of Construction Compliance " - satisfactory to the Commissioner of Healtfiwill ... be submitted. to the Oepartnrorrt, and a' written quarantee will be furnished the owner, his succeisor heirs or. assigns by tne:buiklmi. that said builder,will ppci i1r good operatkp condition any part, of saki `saw* disposal system during' the period of two (2) years immediately, following, ihedste of the issu- anq of the approiritl of the ,Certificate of Construction' Compliance of ;ths original system or any repairs thereto; 2) that the drilled welt described above wltt be located at Yawn on.the approv plan and that skid welI.will.be installed in acco'i with the standards, rules and rogu ens of the Puteam County Di partiviek of hfoNth. OntoV °7 9 7 SignM . P. � P. Add, HUA u l License No h� l is ►evocable for cause or may be emended or modified when considered ham-- F by the missioner of Health. Any charge or alta►ation of, construct n APPROVED FOR CONSTRUCTION This approval expires two yesrs from the date. issued unless_ nstruction of the buikling,has been undertaken a construction requires a no m"it. Approved fovddiissp —oal of domestl sanitary t Ovate supply only. 10/88 Wte, o�r�2l, �/ ® / Title .. _ I i ' .� WONP Re a AM= '577ZE2rr- ?CMR metemteim go mwp*!Gd Wilms Fm Id TO b2 C=Okczo�j-w W0037 sau�*. en to to and in accordance wilih tho standards; rules and reguEtionT Vulnum pr in coun* Dcsiaitw�am o? "IM ,�PPU�OVED FOR CONSTRU , CTIq":,ThiS oppr p O�101 Ouplid's' 600 it" om the data I Mess. con ca tho, building. Ns boon undortaften and Is ` *mulru Rev. � 10/8 ~�" ~~ | ~ DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New.York 10509 (914) 278 -6130 _ APPLICA.TIj0N_ TO. CQNSITRUCT -A . WATER WELL., PCHD PERMIT # �' WELL LOCATION Street Address Town/Village/City l.e Tax Grid Number I . - - WELL' OWNER Name ~GCV. CCU Mailing C. '2_ Address L 1-71 a43 rivate 0 Public .'USE OF WELL cam` primary '2 - secondary' RESIDENTIAL 0 BUSINESS 0 INDUSTRIAL O PUBLIC SUPPLY Q AIR /COND /HEAT PUMP . O ABANDONED O FARM Q TEST /OBSERVATION 0 OTHER (specify CIINSTITUTIONAL O STAND -BY 0 AMOUNT OF USE YIELD SOUGHT gpm /# PEOPLE SERVED 4 /EST. OF DAILY USAG gal 'REASON FOR DRILLING 13 REPLACE EXISTING SUPPLY ji6EW SUPPLY NEW DWELLING TEST/ OBSERVATION 13 DEEPEN EXISTING WELL D: ADDITIONAL SUPPLY DETAILED REASON FOR DRILLING _ WELL TYPE ZDRILLED O DRIVEN DDUG DGRAVEL. OTHER 0 IS WELL SITE SUBJECT TO FLOODING? YES NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. WATER WELL CONTRACTOR: Name �/iJ�f%'/ I•(i/(J Address: LWk4,UCPp ,( f IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO i NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY.FROM NEAREST WATER.MAIN:.. I. `,LOCATION SKETCH SOURCES OF CONTAMINATION PROVIDED ON SEPARATE SHEET VT (date) ( gnat re I PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions ' of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within . thirty (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any andjall water or waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise c_ontamina urface or groundwater. Date of Issue:. 55-?� G%"-` Date of 'Expiration 19�� Permit Issuing Official i Permit i,s Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller • m PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES . .s;,' ... �.. �..... r» .f''.r" ti:. 7 _ ._ -: j:. -:i J.' `• - > �-. _". .,r - .. 1 Y, :,:�.. .G.cmi.Yf .. �-s+ t..�".. i- ,.,.�;'-r_�; y -�y,x . ^'•? .. _: rs,,x. . -..' ,y � . Date 2� .� `� Re: Property of LINGAR CO.; INC. Located at LIn7�i4� C�aJ (T) Fur► Al A VA)-L Y Section 73.L6 Block I Lot Subdivision of L.IKC&,?- SCIBDIVI`�l�t�l Subdv. 'Lot # (,Q Filed Map .h} 293 Date 5 '8 Gentlemen: This letter is to authorize Insite Enain. ing & Surveying p c, a duly licensed professional engineer X (k- RIXFA&i§ >t xgcoxAxSclgx cx� (Indicate) to apply for a Construction Permit for a separate sewage system, to serve the above noted property in accordance with the standards, rules or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction o.f said system or systems in conformity with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Very truly yours, Signed Countersigned / of Pro, ty Jeffrey J. Contel L G �EV�LOPMEtvTGd.� t P. E. , 1�cx&x, # 61931 �1 L11gE�c� �T Address Insite,Engineering & Surveying, P.C. L_ �T' V::�CKRY4 1�JJ, 17 0.43 Address Town Route 22, Brewster, NY 10509 i? 1- A4W Ct700 278 -4990 Telephone Telephone DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT I i # v -743 WELL LOCATION Street Address Town/Village/City Tax Grid Number &( A(CAA d/+A(E PviN" VA t,L 3,1 — 13 WELL OWNER Name l 141CAi; pe LCY'�MF7V`i tF► ii�l Mailing Address 4-jo -� pEniz -,j N_� 6r. �, ' Z L/(3r_� a�. `VFsivate 0 Public SE'OF WELL primary 2- secondary *RESIDENTIAL 0 BUSINESS 0 INDUSTRIAL O PUBLICS PLY O AIR /COND /HEAT PUMP O FARM O TEST /OBSERVATION O INSTITUTIONAL O STAND -BY O ABANDONED 0 OTHER (specify 0 AMOUNT OF USE YIELD SOUGHT gpm /# PEOPLE SERVED + /EST. OF DAILY USAGE _,00 al 0 REPLACE EXISTING SUPPLY O TEST /OBSERVATION 12. ADDITIONAL SUPPLY KNEW SUPPLY NEW DWELLING 13 DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE ®DRILLED DRIVEN DUG []GRAVEL OTHER _1 MLL-. SITE- SUR.JJF.,=..T.A-F14ODING -L- ... IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. (r,' WATER WELL CONTRACTOR: Name Address: L(R/,A /YCcd IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES No Y NAME OF PUBLIC WATER SUPPLY: DISTANCE.TO PROPERTY FROM NEAREST WATER MAIN: LOCATION'SKETCH & SOURCES OF CONTAMINATION PROVIDED (MON SEPARATE SHEET (date) TOWN /VIL /CITY PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirt, (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assurelthat any and all water or waste products from such well drilling operations be contained on this property and in such a anner as not to degrade or othe se contamgi�n/ a surface or groundwater. Date o'f - Issue`:' _ _ :lg x - �., :: , ' �� Date of Expiration 19�/ Pe it Issuing Official Permit! is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller .a �9 INSI TE-q ENRINEERING & , SURVEYING, P.C. Route 22 (914) 278 -4990 Brewster, New York 10509 Fax: (914) 278 -6392 7 DeLavergne Avenue (914) 297 -1742 Wappingers Falls, New York 12590 TO: �CfiD LETTER OF lTG ANA 1NvilUT TQL DATE ! I QS J ! / 7, 30(C7 ATTENTION RE: WE ARE SENDING YOU P(Attached ❑ Under separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of Letter ❑ Change order ❑ THESE ARE TRANSMITTED as checked below: 0--99r approval ❑ Approved as submitted ❑ For your use ❑ Approved as noted ❑ As requested ❑ Returned for corrections ❑ For review and comment ❑ ❑ FOR BIDS DUE 19 _ REMARKS: ❑ Resubmit copies for approval ❑ Submit copies for distribution ❑ Return corrected prints m ❑ PRINTS RETURNED AFTER LOAN TO US COPY -:j0' SIGNED: (5-ft)) 11 endosures are not as noted, kindly nobly us at once :II�tCAR "1.1�.►AJ , ...,� Sti.VE,P.NISION:: 'LI�IZ D�I�l4Pt� t'. �T,�' ,Q,� Subdivision �A>�nro�ed `tip � 5 Nttti.e.ta..d.a �- Yrm Sd� rM S�wwop 87di� b `eIIIttl�t d ti� t 1 ;11� M airlwelaa b� p t 1� k fir+ e IL 1 �� npnant tMt 1 a�miwlwlly nd compWtaIy r.*WnsWIe forjt apow ttater{bid will N "co►iitruetad of trtiwn on�'tha app►ow0,r 601711tt/ sOpNtmantt.�Of t0laaltlry a00 that On k"is fkfn -thii, N` fuenlRt d to she, Opatn �M ` an0; �a w/lttai` �uirantii`i pMe! M�poO�epM�tin/�cOm/ttbn,r�nY 3� of ,pkl tawafa_ dngrot tl�i-ippoval.,of tM.;C}ItNkifr,`ef Ccestructbn Ca i" na baatid'as Miowe on lM appovM plan and ,that fake wal ■�ryrr / 1�M a ant 'vCII►tr�IiM � r'.. jT' wx ��. >1 � Ala, ��..�.1 ft <..v .`.'i 771 -7 t I BEET ?o.. i,L►iTC.� �1L-F Fee Enclosed aror,,,nt�?°Q dC' 4.0 rar Valttioe Plow G P D P(�NNl�tlee b Yep�4ed Wien F101� a�pMOed ' _r 0'�0'?T; aL��, ,`�.i��D�a,!C��o1�'7p.�.�►ct��S a � I Savtle 11ak as + Mi�aa l.1 -4K I�l 1 iJ r ' i t.�1.K l�lo G ru ti. Y. t 1 1 �y WU : ✓ KT :. SR Uk9 i �1 ! 1 n `, t., ` �b .. '...�:: Mid&- an01oution of tha p►OposW �rst�m(q 11 tHat,tM sip�iatocaw di ' tl1 -sVot m the wuwAwa.w�'.fliiri to•nd aw aeeerda'nri:r`rith ' tM i[>•nAaldt•iuNt a1 d.r�0u of o /CI�le t tis T IJ �Si�nW j Y f a t W Roy -►�r1E 'Co L X05► L {c"" Wo ' i APPROVED FOR CONSTRUCT ON• TkM app►Ot>al axpkas,two liom aaN iitivad unlessstructwn of tM buiglny tas bean un0a►takat and is ►0110CabN la':uuM�,o� -may tN anMnrM o► modHkid wMnao11 ►y�0y�' ommip{omtt ot'NYRh.' .Any ifnnya or',altaration "ol oomt►uetk►n /ptiNat a nlll: At orM fa dlmoNl of domas<k a► a��/ t water supply only i v ` Rev,, /�3 A�- I DatN�QL( RY T {tN . - -- i 1 1 ' I I • 1 -t i I i DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 "- °APPLICAT O*� TO''CONSTR'UCT' "Pr'-'WATER=WELL PCHD PERMIT #s -"'_ WELL LOCATION Street � Address 0NC&fZ 1_A� E Town/Village/City Tax Grid Number P.A-r1•iW V��1�1 � 13:1 •- 1 - 13 WELL OWNER Name mailing ddress ®Private L1NG,aNt y VEUXr' +E�.iT g r NG. ZQ�1 �.iP�EQ -T�( ST, UtT1_E FERN'( ►J,l 1 -14o4S ® Public USE OF WELL 1D- primary 2 - secondary 11 RESIDENTIAL ® BUSINESS ® INDUSTRIAL ® PUBLIC SUPPLY ® AIR /COND /HEAT PUMP O ABANDONED 0 FARM ❑ TEST /OBSERVATION 0 OTHER (specify C]INSTITUTIONAL O STAND -BY AMOUNT OF USE YIELD SOUGHT 5 gpm /# PEOPLE SERVED 4 /EST. OF DAILY USAGE _3-0&1 O REPLACE EXISTING SUPPLY ® TEST/ OBSERVATION Q ADDITIONAL SUPPLY &NEW SUPPLY NEW DWELLING ® DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE DRILLED DRIVEN ®DUG ®GRAVEL ®OTHER IS WELL SITE SUBJECT TO FLOODING? YES NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: S02,>i,4 iSic+ j Lot No. MATER WELL CONTRACTOR: Name Ut4K.904J N . Address: �+�K1y01�1 IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES bC NO WAKE OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY I�� DISTANCE TO PROPERTY FROM - NEAREST WATER ;MAIN• - N Yom. _.. .... - .'•...... . .. .... r'a. ......a .a .. si: ..�.c"-s. =F. .cv.. r"easa:. eta ...a ..w- ..e..oY -. v- ..�.V- +w:^- .¢.'r. .r w- r... •.ev-.a ...v.rr. r.-. �H �.. p(�...- �'.�%a.`:t'a'.�a.�1 «.wa W-.n -.o .-•:9- LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ®ON SEPARATE SHEET (date) sir atur ) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirt3, (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance.with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such a ma ner as not to degrade or other a contaminate surface or groundwater. Date of Issue: 19 3 . Date of Expiration 19 Permi Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller APPENDIX 3 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS REVIEW SHEET for CONSTRUCTION PERMIT BY �" DATE DOCUMENTS. Y -Y" i PERMIT APPLICATION I PC -f I WELL PERMIT PWS LETTER ENGINEERS AUTHORIZATION DESIGN DATA SHEET(DDS) �DEEE HOLE LOG ('CONSISTENT PERC RESULTS (3) -PERC HOLE DEPTH CORPORATE RESOLUTION PLANS THREE SETS HOUSE PLANS - TWO SETS VARIANCE REQUEST GENERAL LEGAL SUBDIVISION - SUBDIVISION APP OVAL CHECKED PERC RATE FILL REQUIRED 4 eft-2 CURTAIN DRAIN REQun&D mSTANDPIPES VAL SSDS ADJ. LOTS (TOWN/DEC PERMIT R & D) ATA ON DDS PLANS & PERMIT SAME PRE- 1 ; 969 - NEIGHBOR NOTIFIETCATION -n/ LETTER BI/ZBA 100 YR. FLOOD ELEVATION SEWAGE SYSTEM PLAN - (NORTH ARROW) `SSDS HYDRAULIC PROFILE m GRAVITY FLOW Z] / J BOX M TRENCWGALLEY CD P- PIT DETAILS SEPTIC TANK - SIZE, DETAIL WELL DETAIL, SERVICE LINE IF OVER CONSTRUCTION NOTES (GRINDER RATE) DESIGN DATA: PERC AND DEEP RESULTS -bTWO -FOOT CONTOURS EXISTING & PROPOSED Tl,DRTVEWAY & SLOPES CUT Z FOOTING /GUTTER/CURTAIN DRAINS 'OMMENTS: TAX MAP'# DISCHARGE (OK) PERC & DEEP HOLES LOCATED REPRESENTATIVE OF PRIMARY AND EXPANSION EXP. AREA; SHOWN; GRAVITY FLOW, SUFF. SIZE IZ IF PUMPED PIT & D BOX SHOWN & DETAILED m HOUSE - NO. OF BEDROOMS C WELLS & SSDS'S WAN 200 FT. OF PROPOSED SYSTEM PROPERTY METES & BOUNDS Q] HOUSE SETBACK NECESSARY (TIGHT LOT) HOUSE SEWER - 1 /4 "/FT. 4 "0; TYPE PIPE NO BENDS; MAX. BENDS 45 W /CLEANOUT FILL SYSTEMS rFr BARRIER HORIZONTAL: SL OPE 3:1 TO GRADE SPECS H GAUGES PROFILE & DIMENSIONS UME TRENCH PLF TRENCH. PROVIDED. 60 FT MAX OPARALLEL TO CONTOURS 100% EXPANSION PROVIDED EEPARATION DISTANCES SPECIFIED ON PLAN FIELDS 10' TO P.L.,'DRTVEWAYJARGE TREES, TOP OF FILL', 20' TO FOUNDATION WALLS Z 100 TO WELL, 200' IN D.L.O.D., 150' PITS 100 TO STREAM WATERCOURSE LAKE (INC.EXPAN), 50' TO CATCH BASIN, 35' STORMDRAIN, PIPED WATER 10' TO WATERLINE (PITS -20') M NY INTERMITTENT DRAINAGE COURSE 200 FT. RESERVOIR, ETC.10 150 FT. GALLEY SYSTFAIS SEPTIC TANKS M 10' FROM FOUNDATION; 50' TO WELL WELLS ED 15' WELL TO P. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES kIN - W'. a, Date Re: Property of LINCAP- MVF_LOPMENt CO. IW, Located at 51SKIA H I LL Z D. M-PUtNAM VALLEY Section 13.16 . Block Lot 15 Subdivision of LIU-CA9 11 5UWYL5b Subdv. Lot # Filed Map# 2+ Date qjbl8q Gentlemen: This letter is to authorize -MbliF, ENGINE✓VAW-1 AND MS . no PC• a duly licensed professional engineer or registered.architect- (indicate to apply for a Construction Permit for a separate sewage system, to serve the above noted property in accordance with the standards, rules or regulations as p 9 romula*at'ed by the Commissioner of the Putnam County Department of.Health, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said sys em or syst ems in con:eormity with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Very t Signed Countersigned P. E. A4., # CI FE. IiJ51tF- EW_5IWr=kRIWG AND DE560 EC Address —OWIP-L, Wi- IQ51Z OIA_ 225-OW Telephone , 'Address LMLE EE M K.U. QP43 Town 261-44o-4100 Telephone PnNAM COUNTY DEPARTMENT OF HEALTH.1 Division of Environmental Health Services AFFIJDAVI FOR PERMIT APPLICATION SUBMITTED TO COUNTY HEALTH DEPARTMENT to act for (Name of Corporation)" having offices at 'FERIrf jNJ IXAS ,Whose officers are: Presi-dent: Donald.Nuckel 281 Liberty Street Little Ferry, NJ (176 A 3 (Name and Address) Vice-?resident: (Name and Address) Secretary: ecretary: e Treasurer: (Name and Address) and that I am and will be individually responsible for any and all corporation with respect to the approval requested and all subse thereto. Sworn to before me this -S' day Signed: of 19 q3 Title: Noiiry Public. MLENE FAU5TIN1 NOTARY PUBLIC 0i: P,IEW JERSEY M� 24.1996 Corporate Seal is of the acts r a n - 207, 40 N/F ORL AND O" , , DRIVEWAY " UNDER' "CONSTRUCTION. .100' MIN : _f 1; .I. 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